Preoperative Detection of Cervical Lymph Node Metastases in Papillary Thyroid Cancer: A Surgical Perspective

Onkologie ◽  
2009 ◽  
Vol 32 (12) ◽  
pp. 762-766 ◽  
Author(s):  
George H. Sakorafas ◽  
Spiros Christodoulou ◽  
Christos Lappas ◽  
Michael Safioleas
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

scholarly journals LEVELS I–VII FOLLOWING THYROIDECTOMY FOR PAPILLARY THYROID CANCER

2020 ◽  
Vol 19 (5) ◽  
pp. 76-81
Author(s):  
V. S. Parshin ◽  
A. A. Veselova ◽  
V. S. Medvedev ◽  
S. A. Ivanov ◽  
A. D. Kaprin
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

Introduction. Cervical lymph node metastases can occur not only in patients when they are first diagnosed with papillary thyroid cancer but also in patients who have undergone thyroidectomy. Objective. The aim of this study was to assess the potential utility of neck ultrasound in diagnosing cervical lymph node metastases (levels I–VII) in patients who underwent surgical treatment for papillary thyroid cancer.Material and Methods. B-mode sonography of all nodal levels in the neck was performed using a linear array transducer in the frequency range of 7.5–13 MHz, power mapping and panoramic scan to locate regional lymph node metastases. All lymph nodes removed during reoperations were submitted for histological evaluation. Sonographic examinations of cervical lymph nodes of the levels I–VII were performed in 2875 patients who had undergone thyroidectomy in different regions of the Russian Federation. The patients were admitted to our clinic to receive radioactive iodine therapy. All neck levels were assessed by ultrasound.Results. Sonography revealed cervical lymph node metastases in 267 (9.2 %) of 2875 patients with papillary thyroid cancer who had undergone thyroidectomy. Nodal metastasis in level VI only occurred in 70 (2.4 %) patients, in levels II–III–IV only in 150 (5.21 %), in level VB only in 32 (1.11 %), and at the same time in level VI and in levels II–III–IV in 15 (0.52 %) patients. There were no metastases in levels I, VA, VII of the neck. Solitary metastases to all levels were found in 7.5 %, multiple metastases in 1.2 %, and conglomerates in 0.6 % of cases. Solitary metastases in level VI were noted in 56 (1.9 %), in levels II–III–IV in 125 (4.3 %), and in level VB in 29 (1.0 %) patients. Multiple metastases in level VI were detected in 11 (0.38 %), in levels II–III–IV in 21 (0.73 %), and in level VB in 3 (0.1 %) patients. Median metastasis size was 2.1 ± 1.6 cm.Conclusion. Post-thyroidectomy patients were found to have cervical lymph node metastases. Ultrasound scanning of the neck should be considered a key examination if there are cicatricial changes as it enables to identify metastasis and to determine its location. The maximal number of metastases was noted in levels II–III–IV. Cervical lymph node metastases occurred less frequently in the central level and level VB. The predominant metastatic pattern was solitary. There was an essential difference in metastatic spread to cervical lymph nodes between postthyroidectomy patients and patients who were first diagnosed with papillary thyroid cancer. 

The Pattern of Cervical Lymph Node Metastases in Papillary Thyroid Cancer

2007 ◽  
Vol 7 (2) ◽  
pp. 94
Author(s):  
Yong-Seok Kim ◽  
Yong-Sung Won ◽  
Ja-Seong Bae ◽  
Jeong-Soo Kim ◽  
Byung-Joo Song ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

Does Reoperation for Cervical Lymph Node Metastases Cure Papillary Thyroid Cancer Patients?

2011 ◽  
pp. P3-660-P3-660
Author(s):  
Jayender R Chintaparthi ◽  
Venu M Konala ◽  
Jill E Langer ◽  
Ara A Chalian ◽  
Douglas L Fraker ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

Risk of bilateral cervical lymph node metastases in papillary thyroid cancer

1993 ◽  
Vol 52 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Masakuni Noguchi ◽  
Shinichi Kinami ◽  
Kazuo Kinoshita ◽  
Hirohisa Kitagawa ◽  
Michaei Thomas ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Cancer ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

Presence and Number of Lymph Node Metastases Are Associated With Compromised Survival for Patients Younger Than Age 45 Years With Papillary Thyroid Cancer

2015 ◽  
Vol 33 (21) ◽  
pp. 2370-2375 ◽  
Author(s):  
Mohamed Abdelgadir Adam ◽  
John Pura ◽  
Paolo Goffredo ◽  
Michaela A. Dinan ◽  
Shelby D. Reed ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Cancer Staging ◽  
Nodal Metastases ◽  
Papillary Thyroid ◽  
Cervical Lymph Node Metastases ◽  
Node Metastases

Purpose Cervical lymph node metastases are recognized as a prognostic indicator only in patients age 45 years or older with papillary thyroid cancer (PTC); patients younger than age 45 years are perceived to have low-risk disease. The current American Joint Committee on Cancer staging for PTC in patients younger than age 45 years does not include cervical lymph node metastases. Our objective was to test the hypothesis that the presence and number of cervical lymph node metastases have an adverse impact on overall survival (OS) in patients younger than age 45 years with PTC. Patients and Methods Adult patients younger than age 45 years undergoing surgery for stage I PTC (no distant metastases) were identified from the National Cancer Data Base (NCDB; 1998-2006) and from SEER 1988-2006 data. Multivariable models were used to examine the association of OS with the presence of lymph node metastases and number of metastatic nodes. Results In all, 47,902 patients in NCDB (11,740 with and 36,162 without nodal metastases) and 21,855 in the SEER database (5,188 with and 16,667 without nodal metastases) were included. After adjustment, OS was compromised for patients with nodal metastases compared with patients who did not have them (NCDB: hazard ratio (HR), 1.32; 95% CI, 1.04 to 1.67; P = .021; SEER: HR, 1.29; 95% CI, 1.08 to 1.56; P = .006). After adjustment, increasing number of metastatic lymph nodes was associated with decreasing OS up to six metastatic nodes (HR, 1.12; 95% CI, 1.01 to 1.25; P = .03), after which more positive nodes conferred no additional mortality risk (HR, 0.99; 95% CI, 0.99 to 1.05; P = .75). Conclusion Our results suggest that cervical lymph node metastases are associated with compromised survival in young patients, warranting consideration of revised American Joint Committee on Cancer staging. A change point of six or fewer metastatic lymph nodes seems to carry prognostic significance, thus advocating for rigorous preoperative screening for nodal metastases.

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